Too clean is no good
Antibacterials may lead to resistant bugs and weak immune systems
Sirena Gordon, Healthscout, July 25, 2000
MONDAY, July 17 (HealthSCOUT) -- Antibacterial soaps, antibacterial laundry detergent, antibacterial cutting boards, antibacterial baby toys -- the list just keeps going on. With so many antibacterial products out there, you'd think we'd have germs on the run. Unfortunately, the reality is that all these germ-killing products may end up leaving us even more vulnerable to infection, says a Tufts University microbiologist.
Similar to the concerns over using antibiotics too much, the worry is that overuse and misuse of these antibacterial products will kill off good bacteria and weak bacteria, leaving only the strongest and most resistant bacteria behind.
"The image that germs should be destroyed, and kids should be raised in a sterile home is a mistake. If we over-clean and sterilize, children's immune systems will not mature," says Dr. Stuart Levy, the director of the center for adaptation genetics and drug resistance at the Tufts University School of Medicine in Boston. "What worries me is that if we continue using antibacterials, we won't see [problems] until children get older, maybe 10 years from now," he says.
Most bacteria are harmless, and we need to be exposed to numerous different microbes as we grow to develop the antibodies that make up a strong immune system. If a baby's environment is too clean, says Levy, the immune system may not develop properly. He says recent studies have shown an increase in asthma and allergies in homes that are overly clean.
Levy addressed the International Conference on Emerging and Infectious Diseases in Atlanta, with his concerns today.
Levy says the only place for antibacterials is in caring for the very ill whose immune systems are compromised, but he points out that there are currently more than 700 antibacterial products on the market. He says he does not use them in his home or office, and recommends that hospitals only use them around very weakened patients. People should clean with chlorine bleach, hydrogen peroxide or alcohol, he says. While these products can also be considered antibacterials, Levy says once you have cleaned with them, they are gone. Newer antibacterials, however, leave behind a residue that continues to kill bacteria for some time after you use them, which doesn't give good bacteria a chance to reestablish themselves.
Not everyone agrees that this is going to be a problem, however.
While he agrees that antibiotic resistance is a real concern, and that no one should try to make his environment completely sterile, Dr. Philip Tierno, the director of microbiology and clinical immunology at New York University Medical Center in New York City, feels there is no parallel between the growing use of antibacterials and antibiotic resistance.
He says that none of these antibacterials can kill all germs and there is no evidence of resistance to triclosan anywhere but in a test tube yet. Triclosan is a germ killer and is the active ingredient in many mouthwashes and toothpastes; it is also in soaps, dishwashing liquids and other antibacterial items.
What To Do
Infectious diseases are still the leading cause of death worldwide and Tierno says 80 percent of those diseases are transmitted by touch. Yet, he says, less than 50 percent of us wash our hands on a regular basis and almost none of us do it right.
For this reason, Tierno does recommend using antibacterial hand soaps. "Hand-washing is the single-most important thing you can do to safeguard your health," says Tierno.
A recent HealthSCOUT article details how the most popular antibacterial, triclosan, may act more like a drug than a cleaner, which would put it under government scrutiny.
The American Medical Association recently decided to look into antibacterial soaps amid the questions of their effectiveness and potential for harm, as reported in Doctor's Group Questions Anti-Bacterial Soaps on Dr.Koop.com.
And Nature has more on the triclosan controversy.
SOURCES: Interviews with Stuart Levy, M.D., director, center for adaptation genetics and drug resistance, Tufts University School of Medicine, Boston; Philip Tierno, M.D., Director of clinical microbiology and diagnostic immunology, New York University Medical Center, New York
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